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Complaints & Reviews

bad choice leads to no choices

Chose Humana Medicare PPO with extra premium to avoid doctor and hospital co-pays because previous provider, Optima, stopped serving my state this year. Turns out almost no one in Humana's book or on their web site as Humana providors take Humana. I called Humana and they told me to just call everyone on their list. This is dreadfull. Salesman sold me a bill of goods with Humana. Now I'm paying a premium for a PPO almost no one takes and I have no ability to choose and doctors based on my own research. Medicare won't let me change providoers for another 9 moths and I have kidney stones in both kidneys. What a mistake. Choose wisely and don't believe anything without looking into what real people are experiencing with it.

correction of accounting errors

On 1/1/11, I subscribed to the Humana walmart Prefered Rx Plan (PDP). This plan provides for a $310.00 deducible first. My first six Rx's were purchased at Costco, a preferred retail pharmacy. The total cost was $97.12 which was applied toward the $310.00 deductible. the 7th and 8th Rx's were also ordered from Costco but only one Rx was purchased on May 23, 2011. The drug/ointment Rx was not picked up Cost was about $300.00. Costco placed back on the shelf and a notice was sent to Humana to reverse that purchase. The other Rx, Spiriva, was purchased; my cost was $224.00. Thus On 5/23/2011, I met my deducible, ($224 + 97 = $318 ) the 8th Rx at Costco was $5.00. OK. Now on 7/26/2011 &27 three Rx's from their mail order pharmacy (Right Source) were shipped. The three Rx's were tier 1 or 2 with no copay, I was billed $35.85. It should be at NO COST. I began my long stream of many, many calls to correct this error. Nothing happened, On 8/4/2011 three more Rx's were ordered, Spirvia, cost to me $238.29, Paroxetine HCL, at $47.22 and levothyroxine at 0 co pay, Having met deductible back in May The Sprivia cost should have been $134.45 and the paroxetine $0.00, Thus overcharged $155.02. and having an outstanding due balance of $35.85.. Where is my check??? also the reversal of the $35.85 improperly charged to me.
March 5, 2012; neither has been corrected. I estimate at least 50 + hours on the telephone with Humana supervisors, grievance people and Right source, Few ever returned calls. I never can speak to the same Customer service agent or the same location. What is wrong with your company, How many more hours will I spend at your cost to correct this problem?????

treats seniors poorly

My mother is 76 years old, low income, has dementia and high blood pressure. I switched her from AARP to Humana Walmart Plan for her blood pressure medicine on April 1, 2011. The salesperson assured me that her blood pressure medication, Tiazac 240 miligrams, was on their list of "Formulary" drugs and all we would have to do is pick up her medication once a month at a Walmart pharmacy for a nominal fee. Being that Tiazac is an old medication I explained to the salesperson that the whole reason we were switching her is because AARP had removed the drug from their "Formulary" list and placed it on "Non-formulary" and that I've had all sorts of problems with them because of it. I also explained to him that I had a written note from my mom's physician stating that they have attempted to use generic forms of the medication for her in the past and it was unsuccessful. She can only use Tiazac. The young man gave me a fax number and asked me to fax him the note and he would put it on file so that if in the future Humana took her medication off their "Formulary" list we wouldn't have to go through the same problem again. I was relieved. It all worked great until this month, February. I went to pick up my mom's medicine and Walmart told me it would be $96.50 instead of the normal fee we had been paying of $6.50. Apparently, Humana removed my mom's medication from their "Formulary" list and placed it on the "Non-Formulary" one. I was told that in order to get her insurance to cover the medicine, regardless that her prescription from her doctor is still current, I would need to have her doctor's office fax over "prior authorization" and that the process would take 72 hours. I called her doctor's office and left a voicemail for them to do this and I also waited 72 hours. Today, I called the Walmart pharmacy to see if the matter had been straightened out and was told no. I called Humana at 9 am this morning and that's where the fun began. The representative told me she was unable to speak to me without my mom's permission. I explained to her that my mom has dementia and I'd be happy to conference her into the conversation with Humana by calling her with my 3way calling feature on my phone, however I told the representative to be prepared because my mom talks and talks about things that have nothing to do with the subject at hand and she doesn't understand things very well. The rep said ok so I conferenced my mom in on the call. After 15 minutes of my mom talking about random things (thanks dementia) she finally gave verbal permission to the Humana rep to speak with me. I asked the rep at that time if she would please note in the records that my mom had given verbal permission for them to speak with me in case I had to call them back so that we wouldn't have to go through this process again. The rep advised she was not able to do that, all she could do was send out a written form for my mom to fill out and send back and it takes a couple of weeks. Though frustrated with this information, I continued on with my reason for the call. I asked the rep what the status of the prior authorization was. She informed me that they hadn't received anything from the doctor's office. I advised her that my mother's doctor's office faxed the info the day before. The rep said that it might be in the fax cue but there's no way to tell and it will take another 72 business hours. She said that they could "expedite" it if the doctor's office would give them verbal permission. I said great, can you please conference the doctor's office in on the call so we can get this taken care of? The rep said she is not able to make conference calls and that I could feel free to hang up with her and call the doctor's office and then call Humana back. I pointed out that if I hang up with her and call back she will again need my mom's verbal permission to speak with her and that will take another 10 minutes or more of listening to my mom tell her everything under the sun. She still insisted it was the only way. Rather than hang up with her and have my mom do this all over again, I asked for a supervisor. After several minutes of the rep asking me why I wanted a supervisor she finally complied with my request and got "Denise" on the line. Denise was able to attempt to call the doctor's office but she reached the nurse's voicemail so she was unable to speak to anyone. She left a message with the doctor's office and said that if they would call her back with the prior authorization she would expedite it through and I could get my mom's medicine immediately after. I hung up and shortly after the doctor's office called me and said they had called Humana and gave the prior authorization. Great, finally after 3 hours of being on the phone I could finally get this resolved! I was so happy. I called Humana back and after 30 minutes of explaining to the rep that I needed to speak to Denise and also after conferencing my poor mother back on the phone and having her tell them random stories for 15 minutes before finally telling them they had permission to speak with me, Denise finally got on the phone. She said she received prior authorization and placed me on hold for 20 minutes while she had the "Review Board" look it over to approve it. She finally came back on the phone and said it had been denied. I asked why and she said that even though they received the prior authorization that they still cannot approve it because the doctor didn't specify that my mom can't take generics. I explained to her that they already had this info on file and for that matter so does the Walmart pharmacy we use. She said that didn't matter, they need it again. I asked her if she could conference in the doctor's office again and get what she needed from them this time. She said she couldn't do that, that my mother would have to file an appeal since it's already been denied. I explained to her that we had gotten everything that Humana was requesting and that there was no mention of this prior to them denying the prior authorization. Again, she stated she cannot do anything and it will have to be appealed and it will take 4-6 weeks. My mom has 3 blood pressure pills left. They will run out on Sunday. My only other option is to take her heating bill money and go buy her medicine at full price. The whole ordeal today took up 5 hours of constantly being on the phone. I feel that Humana placed unnecessary requests upon my elderly mother being that they already have this information on file in the first place. I also feel that even after we complied with EVERYTHING they asked us to do they still denied and came up with another unnecessary request that hadn't been mentioned before and is again, something they already have on file. I am at my wits end so I can't even imagine what this all must feel like to other Senior Citizens that have to deal with Humana.

  • Se
    Senioritis Nov 15, 2012
    This comment was posted by
    a verified customer
    Verified customer

    Totally agree. I have experienced this as well. Many times on phone calls, they will place you on hold while they check something out and then leave you on hold for almost an hour. It has been a nightmare. However, I do not know which company to swith to because the other company I had was the same low quality and treated seniors with disdain and no help. Possibly this star rating system may help. In the meantime, I suggest (as was suggested to me) to put in a complaint or grievance with Medicare. That is the only way to make these companies get in line and become ethical.

    0 Votes

misrepresented coverage

I bought dental insurance over the phone. The phone agent told me routine cleanings were covered 100%. I went for a cleaning about 5 months later and the dentist wouldn't honor that. Dentist said plan allowed for an "office visit" charge. Sure enough, it does say that, too. But it is deceptive to say something is covered 100% when to get it you have to pay for something else. I cancelled the plan. I had a hard time doing that, too. The company wouldn't let me, forcing me to stop paying to have the policy cancelled. Their grievance process is a joke. Whatever you do, don't buy dental coverage from them.

  • Sh
    Shawn050780 Feb 06, 2012

    Be careful about dental insurance plans. Many of them are PPO's and require you to visit a dentist within a particular network, or you may have a different pay rate. This sounds something like what you have experienced. Remember to ask detailed questions next time.

    0 Votes
  • Mi
    Mic W Feb 07, 2012
    This comment was posted by
    a verified customer
    Verified customer

    This plan was a PPO and I went to a PPO dentist. I asked very detailed questions when I signed up and was told cleanings were covered 100% at PPO dentists. Not true.

    0 Votes
  • Sh
    Shawn050780 Feb 09, 2012

    Yeah, that does sound pretty deceptive. I have to agree with you. To say your cleaning is covered 100%, but never mention that the office visit is not covered at 100% is pretty bad. Sorry that happened to you.

    0 Votes

Resolved prescription overcharge

Humana uses Right Source as it's prescription service. We received 2 prescriptions that were 2.5 times the cost of 3 local pharmacies. It seems to me that we should not be in a plan that we pay premium for and have to pay 2.5 times the local cost for our medicine.
Suggest: Check with your local pharmacy to determine the cost of a prescription before you turn it over to Humana mail order pharmacy. Each of these Rx were 9.99 locallly for 90 day supply. We were charged $25.73 and $19.86 by Humana-Right Source. No one there seems to have the authority to adjust this.

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humana customer service

Every time I try to get something straight with Humana Customer Service, the more I find out how "stupid" and "untrained" their agents, and "supervisors" are. Is there anybody with this company that can improve the service they currently do not give their customers.
I have a wonderful agent, who sold me the policy, and she has told me to call her when ever I need anything, and don't even bother calling "Customer Service".
There has to be somebody with this company, that wants to improve its customer service dept.

Resolved cancel plan

In summary, this is a very poor dental plan with very few dentists accepting the plan. My dentist explained to me that Humana would not cover some routine checkup procedures that every other dental insurance company would cover. I called and cancelled my Humana Dental plan on June 6, 2011. That lady said the plan would be cancelled by the end of June with no premium deducted in July. Sure enough, my credit card got hit in July so I called and the second lady said she would RESEND the cancellation request even though the first one was still on file. Two weeks later I called and was told that it takes 30-60 days to cancel the plan which is not what the first lady told me. Each time i was promised an email or call to confirm the activity...nothing happened.

Today is July 19, 2011...

  • Ha
    haikanis Sep 19, 2012

    HUMANA DENTAL PLAN IS THE WORST DENTAL PLAN I EVER DEALT WITH..I SIGNED UP WITH THEM TWO YEARS AGO..THINGS DID NOT GO AS I WAS EXPECTED..THEY HAVE A POOR CUSTOMER SERVICE..THEY WILL SIGN YOU UP FOR A PLAN BUT THEY DONT EXPLAIN THE PLAN CORRECTLY, WHAT % COVERED OR WHAT YOU PAY FROM YOUR POCKET...ALSO THEY WILL SIGNED YOU UP ON AUTOMATIC BILL PAY ON YOUR CHECKING ACOUNT...FIRST THEY TOLD ME IF YOU UPGRADE YOUR PLAN TO $19.99 A MONTH YOU WILL GET UP TO $1500.00 COVERAGE EVERY YEAR..SO I SIGNED UP FOR $19.99 MONTHLY PLAN..NOW I WENT TO DENTIST FOR YEARLY CLEAN UP AND X=RAY . WELL GUESS WHAT THEY ONLY PAY 50%...OF THE TOTAL BILL..ON MY OLD PLAN I WAS PAYING $15.50 A MONTH AND I WAS GETTING FREE CLEANING AND FREE X-RAY EVERY 6 MONTH...NOW I'M PAYING $4.49 MORE A MONTH ..AND I HAVE TO PAY 50% OF CLEANING AND X=RAY .. SO NOW I'M WAITING FOR AUTHORIZATION FOR A FILLING .IT'S BEEN OVER A MONTH...SO I CALLED HUMANA TO FIND OUT WHY IS IT TAKING SO LONG FOR AUTHORIZATION ...THEY TOLD ME THEY DONT HAVE A RECORD OF IT..SO NOW I HAVE TO CALL MY DENTIST AND GET ANOTHER ELECTRONIC AUTHORIZATION AND WAIT ANOTHER 60 DAYS..FOR A SMALL FILLING AND I HAVE TO PAY 50% FROM MY POCKET ..SO MUCH FOR HUMANA DENTAL ..SO I ASKED THE REPRESENTITVE THAT I NEED TO CANCEL MY MEMBERSHIP..SHE SAID YOU HAVE TO SUBMIT US A LETTER ...WILL TAKE UP TO 60 DAYS AFTER WE GET THE LETTER...I DONT KNOW WHY I'M PAYING $19.99 A MONTH...THIS COMPANY NEED TO BE AUDITED BY TEXAS MEDICAL BOARD..THEY ARE RIPPING PEOPLE OFF.I SPENT OVER $5000.00 ON DENTIST FOR A ONE CROWN AND ONE BRIDGE..THAT IS AFTER THE INSURANCE .I'M STILL PAYING FOR IT ...MY BLOOD PRESURE AND STRESS LEVEL IS GOING UP I HAVE TO STOP...

    0 Votes
  • Nh
    Nhu Apr 14, 2014
    This comment was posted by
    a verified customer
    Verified customer

    I have same problem cancelling my contract because I was covered by another insurance. Every time I called them, I could only listen to an automated call system and finally was disconnected! Four months passed and charges kept incurred. I have just read a news that they were sued by Doyle in Missouri alleged same issue as mine. They really really deserve it!

    -1 Votes
  • Nh
    Nhu Apr 14, 2014
    This comment was posted by
    a verified customer
    Verified customer

    I was covered by another insurance plan and attempted to cancel my HumanaOne policy. I called them back in November but only encountered by an automated call system. I finally went to their website and sent them an email. No response but charges incurred continuously every month until now. I tried again last week to contact them but same problem, an automated call system and finally got disconnected. Just tried to email them again from my personal email address so that at least they cannot refuse not receiving my request even though it sounds kind of late! Humana really deserve a lawsuit like the one was filed last January 2014...

    0 Votes
  • Sa
    Sandra Bush Apr 13, 2018
    This comment was posted by
    a verified customer
    Verified customer

    I got an Humana Dental plan ad in the mail. Before I recycled it I called Humana Dental One. Spoke to a fast talking woman and she was confusing and just wanted to sign me up now. Told her that I would have to check out the dentists in my area to make sure they are not in a large chain where they are all employees and own their own practices.
    It's better to contract your own price with a local dentist than these crooked insurance companies after the age of 65 you are pretty screwed on dental care in the USA, and $1500 a year won't cover ONE tooth. Why has nothing changed here in Dental care?
    You can go to Mexico and get a great crown(Porcelain) and pay $100.00 for it and have nice a little trip and scuba dive or whatever. Why are they coming to this country? I think Mexico looks pretty good for dental care and RX as well. I hope Pres Trump will address the criminality of medical care and dental care or non care in this country soon as it is all a Medical Dental Industrial Complex scam on Americans and it's got to end and crooked politicians lining their pockets to protect them has to be front page news.

    0 Votes

Resolved rude and ineeficient customer service

I Must say that earlier i thought that outsourced customer service agents (sometimes) were rude and incapable of providing a quality based service especially in healthcare ..but after talking to customer service agents right here in this country it made me feel that Humana is deplorable and pathetic and much more worse in customer service than those outsourced customer service agents from other countries ..They tend to forget that Customers are the reason that they have their JOB's and are able to pay their BILLS on TIME ..Never in my expierence i have seen the customer service agency being so deplorable ...What happened to our once customer centric focus agenda has it died down ...in past 10 years...SHAME HUMANA ...HIRE RIGHT PEOPLE ...Dumping you as my helth care agency and getting relieved of your stincky stock...
ADIOS

  • Ja
    jat3clove Jun 22, 2013

    I too experienced horrible customer service from Humana. They are the provider for my employer USAA. They treated my HSA dollars as if it was their money not mine. They delayed a claim long enough to deny part of it and keep my unused HSA dollars. Really a terrible company. Humana needs to be investigated and run out of business.

    0 Votes
  • Cl
    Clashea Jul 29, 2015

    Everyone talks about the customer service as if their job is great, people call in rude to them, calling them name and stupid when they are only working with what is given to them. some of these issues is correct and accurate however don't make excuses for information you alreasy have in your lap. YOU choose the plan not the other way around, but its everyone else fault for the plan YOU chose, so no one reads anymore because this informtion is sent to you before the plan begin, but you call in get all angry at the customer service agent as if its there fault for your plan you have chosen. So the same way you say customer service is rude, nasty, not compassionate etc etc. try to show that when you call them since you want a HUMAN to assist you but when you get that human you treat them like trash and expect fro them to take them, yes it customer service given to you but this is why alot of company does have computers because no one is willing to deal with the crap you give to them and all they TRYING to do is help you but you make the transaction hard, they don't have nice desk and a fancy office or get paid so much. These people are side by side (that's why you hear other people) getting paid 8.00 a hr trying to help you. it goes both ways. And all you gonna do is repond negativity by saying they don't have to work there but then you won't have a HUMAN to speak to either. compesh!!!

    0 Votes

I definitely do not recommend them to anyone and I feel sorry for the seniors who think humana's medicare plan will help them

Your insurance coverage details are outlined in what is called your 'certificate of coverage'. Surely you can access this from Humana's website. No, it is not available on the web. I called Humana and was told they would not send it to me. Tiffany told my husband that she could look up our plan to reference our certificate, but it would take a couple of days. This was one of many calls where we were told something different each time we called.I have Humana Healthcare from the city I retired from, and I moved to a rural area. I was able to find a doctor on the plan. He is not close to a lab and has permission to send his lab work to the Hospital two miles away, to be tested in their lab. It was catagorized as lab work only. It was a blood test on blood drawn at the doctors office... $15 co-pay and $10.00 lab work. Oh, No!! I was charged an outpatient Hospital deductible of $100.00 By Humana's definition... an Outpatient is treated at the Hospital and confined for a period of less than 23 consecutive hours. When I argued that I was never physically at the Hospital, and therefore did not fit the definition...I was told that 'My Blood, which is a part of me' was there...so I had to pay as an outpatient. My husband needed a stress test and went to a Cardiac Clinic in a Larger City that was In-Network, so we figured we were safe. Wrong! One of the employees that was on the bill, was not In-Network. This place had over a hundred employees. We have Tiffany on tape saying that it is the patient's responsibility to check each and every person, at the facility, who could possibly be involved in your treatment... prior to treatment...even if there are hundreds. It doesn't say that in the certificate either. This company makes it nearly impossible for you to find out what your coverage is, and then changes the wording in the agreement to find a way to deny coverage or get a larger deductible. My husband and I have spent countless hours dealing with this company, on more ridiculous issues than I can relate here. I do have tape and documentation, though...for every claim. We are currently in the appeal process and if The City did not have a contract with Humana, I would not use them. I definitely do not recommend them to anyone and I feel sorry for the Seniors who think Humana's Medicare Plan will help them.

  • Le
    Leo1 Jul 18, 2009

    Humana refused to address my request to disenroll in the medicare prescription program. I was given false information by a representative who did not inform me that I did not qualify for Humana as I already had insurance from my job and when I tried to disenroll I was given the run around (i.e. medicare guidelines, closed open enrollment, failure to file grievance within 30 day period, etc.) So, for 3 years I paid for insurance I did not need or use.

    The Medicare guideline are set up to protect the insurance companies not the American people. BEWARE.
    Who do we have to protect us? The lobbyists are in bed with congress...

    0 Votes
  • Br
    brookiebaby Oct 20, 2009

    consumers should be educated about their insurance.

    0 Votes
  • Ho
    Home and Hospital Sep 06, 2012

    This is one of the worst insurance companies ever. They have absolutely no idea what Medicare's procedures and guidelines are and therefore are not able to follow them. They should be removed from being a Medicare HMO provider.

    0 Votes

people at humana were incompetent and now my credit report has been tarnished

Human Dental paid for a claim. According to Humana, they then later denied the validity of the claim, after almost 1 year, and then said I owe them money. They never tried to contact my Dentist who did the billing or myself. I have no record of an original attempt to collect repayment. And the billing department at the Dentist office verified they had never been contacted.This happened in September 2006. And even so, the originally billing to them was correct and, should have been paid by Humana. Now in December of 2008, Finance Systems of Green Bay, on behalf of Humana, has blemished a perfect credit record. Even after I told them this was a incorrect billing error on Humana's part. People at Humana were incompetent and now my credit report has been tarnished.

does not comply with policy

Humana keeps using excuses not to pay according to my daughter's policy. The claims come back as "penalty applied for not obtaining pre-authorization, " or they don't pay within the 15 business day time period required by the state of Georgia, or they claim there is a co-pay owed. In 2010, my daughter made 5 trips to one doctor. Same excuses. We fought it, and they finally admitted they should have paid. The doctor got paid in March 2011. We reported them to the Insurance Commissioner numerous times. In all instances (there were 149 claims in 2010), they were supposed to pay 100% of the charges according to the policy. We even sent them a copy of their own policy. After spending countless hours on the phone every week, they finally finished paying the claims for 2010 in March 2011. We record all the telephone conversations using Record My Calls.com. When they find out we have recorded, they are much more likely to cooperate. We are having the same problems this year still. If anyone else in Georgia is having a similar problem, please comment. It might be worth talking to an attorney.

  • Ma
    Mad Hornet Jun 29, 2011
    This comment was posted by
    a verified customer
    Verified customer

    Anybody interested in pursuing a class action suit against Humana in Georgia? It only takes 10 people. There has already been a successful one against them and other insurance companies for using the national database, "Ingenix" created by United Healthcare to set rates that were skewed down for paying out of network doctors. Other insurance companies, like Humana, consulted this database and used the rates, and thus required patients to pay more than they should have. United created the database and "scrubbed" it to eliminate valid high charges by out of network physicians. The other insurance companies consulted the database (which was illegal for them to do) and then sent out EOB's that did not pay the physician enough and left the patient with a high bill that the insurance company should have paid. If the physicians can successfully sue these big companies in a class action suit, so can consumers. Harley Tropin is the Miami attorney who led the lawsuit.

    0 Votes
  • Jb
    jbfirebird Jul 20, 2011

    how do people come up with these assumptions about insurance?

    0 Votes

big time ripoff

For some reason i have been recieving someone elses mail from humana of kentucky, i even called them and let them know there's no one here by that name or address, they said the only way they can change that is for the person who's name is on that mail is the only one who can authorize that, talk about BS! i've even sent the mail back to them, they still don't get the message, they still send this mail to me, humana refuses to help, what is WRONG with these people? don't they understand english? how can someone use your personal address if they are a member of humana and get away with this? i guess they just like wasting tons of paper for nothing, talk about harassment!

  • Fr
    FrenK88 Nov 14, 2009

    I'm retired and have Medicare health insurance. I signed up with Humana's "Medicare Advantage" program with the cost being around $79.00 a month. I took the option of having the monthly charge automaticly deducted from my SSI benifits each month, instead of having to send the payments in myself. After six months, Humana informed me that they were unable to collect the $79.00 a month from SSI and that I owed them over $700.00 in back payments. I asked why did they wait six months to tell me, why didn't they tell me the first month they were unable to collect from SSI. I never got a straight answer, never understood why. Also, after having cataract surgery, I later found out that they were not paying what they were supposed to on my claims, not even as much as Medicare alone would have paid. I have not paid the $700.00 and I'm not going to. To *** with them, they try to screw me, I'll screw them right back.

    0 Votes
  • An
    AnonEmos May 18, 2011

    You're an idiot. Humana, along with all other medical-related businesses, CANNOT do anything, including access an account, without the expressed verbal consent of the member on the account. What you should have done is contacted the member who's mail you're recieving and let them know so that they can take care of it.

    0 Votes
  • An
    AnonEmos May 18, 2011

    Very true. Humana can get in a lot of trouble for sending information to someone not on that particular account. But from what I read, a LOT of people dont like this company...

    0 Votes
  • Ce
    cedarkid May 23, 2011
    This comment was posted by
    a verified customer
    Verified customer

    MAY 23, 2010 - I am having a similar problem. Payments in 2010 were supposed to come out of SSI. They called today 05/23/2011 almost a year and a HALF later and said SSI did not make my 2010 Feb and Mar payment. Oh Yeah, they showed a JANUARY 2010 payment and APRIL thru DECEMBER but no FEBRUARY AND MARCH payment and I HAD TO PAY IT OR IT WOULD GO TO COLLECTIONS. SEVENTEEN MONTHS AGO!!! AND NOW HOW CAN I PROVE SSI PAID THEM FEB AND MARCH!! AND THE THREAT OF A COLLECTION AGENCY IF I DON'T SEND PAYMENT RIGHT NOW!! What kind of accounting do they have?

    0 Votes
  • Jb
    jbfirebird Jun 11, 2011

    actually, if the address on file is what they are sending to, its not their fault. HIPAA regulations wont apply. if the policy that you are receiving the correspondence for, is group insurance, Humana may not be able to change the address. i dont work for humana, so i dont know how they operate. i do work for a competitor. we dont have the ability to change addresses without an update from the employer that the group insurance is through.

    0 Votes
  • Ce
    Cecelia Bosch Nov 09, 2011
    This comment was posted by
    a verified customer
    Verified customer

    I had an initial pcp referral for a specialist. I was given a subsequent visit but was not informed that I would have to have a second referral to the same specialist for the next appointment.
    I was not aware that I had to have a separate referral for each visit to the same specialist originally referred to. this is ridiculous and should not be have been denied payment to the specialist. Your policies are confusing and I am thinking of changing ins. Claim for 1/25/11.
    Cecelia A Bosch ([email protected])

    0 Votes
  • Jb
    jbfirebird Nov 10, 2011

    probably should have inquired about that before going instead of assuming. you are an adult, you should check these things before you go

    0 Votes

Resolved dental insurance commercial

This is an extremely annoying commercial showcasing a child's voice counting all the ways Human Dental can save you money. It has a little girl cartoon which I assume is suppose to be cute but I find it so annoying and irritating that it's actually succeeded in turning me off to Humana Dental and because of that commercial I would pick any other dental insurance before I would consider Humana. Please convince this company to pull this commercial off the air.

stay away

Human Dental paid for a claim. According to Humana, they then later denied the validity of the claim, after almost 1 year, and then said I owe them money. They never tried to contact my Dentist who did the billing or myself. I have no record of an original attempt to collect repayment. And the billing department at the Dentist office verified they had never been contacted.This happened in September 2006. And even so, the originally billing to them was correct and, should have been paid by Humana. Now in December of 2008, Finance Systems of Green Bay, on behalf of Humana, has blemished a perfect credit record. Even after I told them this was a incorrect billing error on Humana's part. People at Humana were incompetent and now my credit report has been tarnished.

unethical practice

Your insurance coverage details are outlined in what is called your 'certificate of coverage'. Surely you can access this from Humana's website. No, it is not available on the web. I called Humana and was told they would not send it to me. Tiffany told my husband that she could look up our plan to reference our certificate, but it would take a couple of days. This was one of many calls where we were told something different each time we called.I have Humana Healthcare from the city I retired from, and I moved to a rural area. I was able to find a doctor on the plan. He is not close to a lab and has permission to send his lab work to the Hospital two miles away, to be tested in their lab. It was catagorized as lab work only. It was a blood test on blood drawn at the doctors office... $15 co-pay and $10.00 lab work. Oh, No!! I was charged an outpatient Hospital deductible of $100.00 By Humana's definition... an Outpatient is treated at the Hospital and confined for a period of less than 23 consecutive hours. When I argued that I was never physically at the Hospital, and therefore did not fit the definition...I was told that 'My Blood, which is a part of me' was there...so I had to pay as an outpatient. My husband needed a stress test and went to a Cardiac Clinic in a Larger City that was In-Network, so we figured we were safe. Wrong! One of the employees that was on the bill, was not In-Network. This place had over a hundred employees. We have Tiffany on tape saying that it is the patient's responsibility to check each and every person, at the facility, who could possibly be involved in your treatment... prior to treatment...even if there are hundreds. It doesn't say that in the certificate either. This company makes it nearly impossible for you to find out what your coverage is, and then changes the wording in the agreement to find a way to deny coverage or get a larger deductible. My husband and I have spent countless hours dealing with this company, on more ridiculous issues than I can relate here. I do have tape and documentation, though...for every claim. We are currently in the appeal process and if The City did not have a contract with Humana, I would not use them. I definitely do not recommend them to anyone and I feel sorry for the Seniors who think Humana's Medicare Plan will help them.

  • Jb
    jbfirebird Jun 11, 2011

    sounds like you need a lesson in how insurance and what medical terminology is. i would like to disclose that i DO NOT work for humana. i do work for a competitor though. alot of bad rep is given to insurance because of not knowing. which, seems to be the case here.
    the company i work for, we also cannot send out the outlines of coverage. with retiree plans or group plans, the employer would have these to send out.
    the first large discrepency with your complaint is sending blood work to a hospital. you argue that its not outpatient. its a lab. Yes, it is a lab. but a hospital is an "outpatient facility". a lab would be a free standing company that would do only lab work. they would not be part of a hospital. LabCorp and Quest diagnositcs are examples of what a lab really is. if you send bloodwork to a hospital, it is going to come back as outpatient hospital.
    as far as being billed for out of network...that one is always a touchy subject. it is true that its your responsibility to ensure who treats you, is in network. if you go to an outpatient facility for a stress test, your going to get a bill from the facility and from the physician. ya, you checked to make sure the facility was in network, what about any other parties that are going to submit a bill also? saying it isnt your responsibility is just trying to place blame on someone that it doesnt belong to. your a grown person, you have every ability to take care of things yourself. i hate to sound blunt, but there are alot of people that try to throw an excuse to save some face.
    i know for sure that humana has a website that allows its members to view their providers and your member benefits.
    insurance companies dont try to find loopholes to not pay. but, they are going to strictly follow the medical terminology and what an employer puts in its retiree or active employee benefit package. insurance companies dont make money off of how things are processed. you pay the providers for each individual service that you recieve. not the insurance. so, for these services that they arent covering for some reason, the bill isnt coming from humana. it will be coming from the doctor and the doctor wont be sending money to humana.

    0 Votes
  • Je
    Jerry A May 05, 2012

    My wife needs high blood pressure medication. She has tried several types and the doctor recommends one type only, all the others cause here to faint, blood pressure drops and she goes out. Humana keeps insisting that she use the cheaper drug ( they are the ones she has problems with) but Humana will not help pay for them, and tell the pharmacy to change the prescription. We have submitted forms from the doctor as to what type she needs to take. Humana is playing doctor. Who do we call to fix this??

    0 Votes

Resolved medical malpractice

We are being victimized by the medical establishment. Humana is our Insurer.

I have been on a regime of prescription drugs that stabilized my medical condition for many years, at least seven!
My primary Humana physician Dr. Brian Marks and his cardiovascular specialist Dr. Kent Y. Chen decided that it was time to move in for the kill, writing authorizations for refills for their prescriptions that would inevitably require us to purchase high-cost medications they were profiting from by kick-backs.
In particular, they only authorized refills that would in effect reduce my Warafin Sodium (i.e. Coumadin) dosage from 3.9 mg per day to 2.5 mg. And order costly ProTyme tests to prove the inadequacy of this regime, which is a foregone conclusion.
This is an obvious rip-off we cannot accept.

customer service

Really difficult company to deal with. I recently signed up for Humana/ Compbenefits dental plan through my credit union. I sent in my first premium as instructed in Nov. 2010. In December they double drafted me which left my account $2.00 overdrawn and my payment was refused. The bank in turn charged me a $29 OD fee. (Had they billed 1 month as they were suppose to by contract I would have not incurred this cost) So by January 2011, I was in the hole not only for 2 months premiums but also an additional $29 fee assessed by my bank. I am fully disabled with MS and am confined to a wheelchair. My budget is limited and allows me only enough each month to pay for necessities. I deposited my monthly premiums as they were due and was never aware there was a problem with my account until March when I broke a tooth and needed to actually USE the benefits I thought I was paying for. My account with Humana had been closed since January. I contacted Humana and was told that even though THEY created the problem, they were not able to correct it, or return any of the money that I lost due to THEIR error. I was told if I wanted to be reinstated that I would not only have to absorb the cost I already incurred but ALSO give them an additional 4 months premiums to catch up to May 5th. I tried to compromise by saying, ok, let's forget about the initial money that I am out of pocket and let's start this over. "Can I give you a check today to start this over effective May 5th?" That seems fair, right? NOPE! They expect me to pay them for 5 months premiums on a plan I didn't have access to on top of already absorbing the cost of the original malfunction which they admit was totally their fault. I have been through several customer service reps. Each one has been individully rude, uneducated and very UNhelpful in this situation. I've had better service at the DMV.

  • Tu
    Turtle73 May 03, 2011
    This comment was posted by
    a verified customer
    Verified customer

    I am OP's wife. I would like to add my frustrations to this thread. I have been a member of Humana compbenefits for a year now. I second the opinion that they are poor quality. I originally went with them becuase they offered discount rates to credit union members. Upon receiving my start up letter (One page that says welcome, visit our site) I logged in to their website. It is extremely difficult to navigate. Logging in takes you to your benefits page. Once you select your plan # it directs you to choose a new provider. If you try to use any other function, it directs you to the Provider Only website of which customers have no access. In order to get back to your plan, you have to re-log in. Regardless, I have other complaints. The first provider I chose - Staff was friendly on the phone. The day before my first scheduled appointment my selected provider killed 3 people in a DUI accident and was arrested. I contacted Humana to ask them to waive the 30 day waiting period for changing providers which they did accomodate. I was seen by Dr. Gargasz at Downtown Dental quickly however, when I arrived at the office I was greeted by a customer that was dirty and not wearing any shoes. He appeared to be intoxicated. I made a quick comment to the receptionist about him and was informed that is normal there. I was told" You should have seen the one that was in here earlier, he was high on Oxycontin" apparently that customer informed them of their intoxicated state and was still serviced. At this point although I was nervous, I didn't have much choice. I needed to see the dentist to troubleshoot a loose crown. I waited over an hour and finally made it to the back. I was met by a lady that covered her mouth as she yawned before she told about how late she was up the night before. After about 20 attempts to get bitewing xrays, I had to position the plate myself for her. She left the room and I was left for another half hour or so. Then the dentist came in. He was a young stud (he thought) and had a very full of himself attitude. I mentioned the reason I was so rushed to see him was becuase of the other Dr.s DUI involvement. His response was "It can happen to any of us" and continued over to his computer to look at my xrays. At no point did he look in my mouth yet he came up with an estimate for over $5000 worth of reconstructive procedures that I needed. I just had all my metal fillings replaced 2 years before so I know it was very impossible to need that much work. A new crown maybe, 5k worth of reconstructive work is ridiculous. I told him I would need to think about it. I received my cleaning and left (which by the way was nice. The hygenist should seek employment somewhere else. She's a rarity in this office)...6 months later- I am scheduled for my routine cleaning so I go ahead with it. I informed the staff 2 weeks before my scheduled appointment that I have lost a small bit of one of my fillings (eating candy) and can it please be addressed at my appointment. I was told no problem, we'll put it on your chart. I took time off work and went in for my cleaning/ filling. When I arrived, it appeared empty with the exception of 1 lady in the waiting room. I was called to the back and had my cleaning then was told I was all done. I said wait, I need to get my filling fixed still. I was then told that if I wanted to be seen by the dentist I would have to wait until all the other people were taken care of. I said ok, "How long do you think that will be?" I was told the guy next to me was next and he had been there since 9am (It's now after 1pm). I asked the receptionist if it would be ok to leave if it was going to be a long time (I live 3 miutes from the office) and they could call me with a 5 minute warning. This appeared to be no problem and after confirming my number I was on my way. I received my call at 4:30pm. I was told there were still people there and that they would not be able to see me. Where did they hide all those people if they were so busy? I mean seriously, it's a small office. Aside from the service, let's talk about cleanliness. Although the office did have all the proper plastic covering, I'm not sure they change them after each person. The blue tape on the overhead light was splattered and the headrest sleeve was quite worn. When the assistant came in, she put on gloves then reached for the light, typed a little on the computer and wrote some stuff down with a pen that had been rolling around. After all of this she attempted to come at my mouth with those gloves. Are people aware that gloves are there for MY safety...not hers. I couldn't believe she wanted to put her hands in my mouth after touching all that dirty stuff. Anyways...I feel a little lighter now, thanks for listening to me vent. Hey Humana----> get it together. I called Humana to ask about reviews for their providers. I was informed they don't screen them and that it's my responsibility to "do the research" The next research I do is going to be for a new dental plan.

    0 Votes
  • Ij
    IJRC Mar 13, 2012

    Humana Compbenefits is a scam. I picked this dental plan that was offered by my employer only to find out that Humana and all of the dental providers worked hand in hand to scam the consumer. I recently took my family in for their routine check up and dental cleaning. Each individual I took needed crowns which cost $500-$600 for each crown. What a coincidence I needed one crown, my older son needed a crown and my youngest son 17 needed two crowns. When it was time for our cleaning which was free. We needed deep cleaning which for my son was $50 extra but myself was $200 just for a cleaning. I advised them that I just wanted th routine cleaning offered for free which my insurance company would pay them. Instead I was told that if I did not select the deep cleaning that I would get no cleaning because they would only do the services that they recommend. I complianed to Humana who told me to choose another provider. All of the providers under the plan had the same ideology. You either pay what we tell you or you get nothing. Last time I checked this is called blackmail... So, to sum I am paying for this health insurance plan every pay period that I cannot use because in order for me to use the plan I have to pay for their overpriced dental care. Instead I have been going to other dentist without using this insurance plan and paying less for my dental care. I got a dental cleaning along with x-rays and check up for $60 per person. I am writing about this experience in hopes that someone will read this before making the mistake I made. Humana compbenefits is a money making scam at the consumer's expense. Don't fall into the trap about their low cost premiums because once you go to their dental providers they will tell you that you will need services that are not covered and you will be charged high cost for dental work. You will still be paying the premium to Humana but will not be able to use the coverage. You are better off finding a honest dentist and paying honest prices.

    0 Votes
  • Lo
    Lorri Dahman Sep 20, 2018
    This comment was posted by
    a verified customer
    Verified customer

    Really difficult to deal with. I work at a dental providers office and simply wanted information regarding a patients benefits and co-payments. This seemed to be a bit to much for the benefits department, the claims department and the financial department. I asked for a supervisor several times and was never connected. I was transferred 6 times, the last time to the medical department and was told after 1hr and 14min and 10 sec that i would need to be transferred again to dental . I am so frustrated .

    0 Votes

deceptive practices

After buying glasses for myself with Humana insurance and buying glasses for my sister in law without...

fraud, theft

Humana has been charging me for something I never ordered, nor needed.

This is but a very small portion, representative of the several years that I have dealt, unsuccessfully, with humana... I would switch companies in a nano - second, but sadly, tragically, for many — they're all the same.

(That physicians have allowed themselves to be "owned" and manipulated by hmo's is a mystery to me,)

Although these messages are meant to be confidential, I just copied/pasted the latest useless exchange with this fraudulent company.

I have removed identifying info

*my annotations*


Hello,
The ppo plan should never have been active!! I was charged for something that I clearly did not want or need and most of all, requst. You forgot the part about crediting my account. This is the third year in a row that this "reputable" company has perpetrated this fraud; it needs to be corrected.
Thank you,


— original message —
From [protected]@securemail. Humana.com
Date wed 03/23/2011 06:21:11 pm
To [email protected]
Subject re: re: re: billing [#]

Dear,

Thank you for your recent inquiry submitted through the humana message center.

Your enrollment shows the ppo plan is not active.

If you have further questions, please continue to use the message center or call our customer care department at [protected]. If you are speech or hearing impaired, call 711.

Thank you,
Pam j.
Web customer care specialist
Humana insurance company


— original message —
From: [email protected]
Date: 3/21/2011 2:34:51 pm
To: [protected]@humana.com
Subject: re: re: re: billing [#8]

A partial answer — was the ppo canceled on 01/01/11??? I am being charged for this. I need to know that the erroneous charges have been removed.

* as is their custom, they completely ignored my query in their response — in fact they have ignored it for three years, charging me for something I did not want — or need*

— original message —
From [protected]@securemail. Humana.com
Date mon 03/21/2011 06:16:19 pm
To [email protected]
Ssubject re: re: billing #]

Dear,

Thank you for your recent inquiry submitted through the humana message center.

Effective 01/01/2011 you are enrolled with humana gold plus h24 (Hmo) effective 01/01/2011. No premiums for humana gold plus h248 (Hmo).

*yet, they are still trying to collect*

*yet, they charged me for another plan, that I informed them numerous times, that I did not want or need*

You can file an appeal. Humana will accept written appeal from a member or an authorized representative expressing dissatisfaction with humana’s adverse determination. Mail your written letter of appeal to the following address:

*an appeal is useless — I did that and it "could not be found"*

Humana insurance company
Attn: grievance & appeals manger
P. O. Box 14165
Lexington, ky 40512

Please include a description of your request for the reconsideration of the processing of the claim or desired benefits. You will also need to include your member id number, group number, patient's name, date of birth and supporting documentation within the letter's content.

If you have further questions, please continue to use the message center or call our customer care department at [protected]. If you are speech or hearing impaired, call 711.

Rose


— original message —
From: [email protected]
Date: 3/18/2011 4:18:21 am
To: [protected]@humana.com
Subject: re: re: billing [#]

3/17/11
This is the 3rd year in a row that humana has extracted money from me through manipulation and trickery.
In numerous phone conversations, for the last three years, I have repeated that I have gone to an hmo and yet humana erroneously charged me for a ppo, despite my verbal — and written — requests to cease and desist. These are not mindless mistakes — this is theft — more of what the countless online complaints describe.
And here it is, year three and it's happening all over again.
I will be adding my humana [redacted] to these many consumer sites. You can fool all of the people some of the time...

— original message —
From [protected]@securemail. Humana.com
Date tue 03/01/2011 04:03:25 pm
To [email protected]
Subject re: billing [#]

Dear ms.,

Thank you for your recent inquiry submitted through the humana message center.

This issue has been forwarded to our enrollment department for review. If you need to contact us in the future about this issue, you may use reference #428. You do show active on both plans at this moment, the hmo and the ppo. Please use your hmo id card for any medical costs.

Thank you for contacting humana to receive guidance when you need it most.

If you have further questions, please continue to use the message center or call our customer care department at [protected].


Alissa f.

Web customer service representative


— original message —
From: [email protected]
Date: 2/26/2011 9:09:24 pm
To: [protected]@humana.com
Subject: billing

Hello,
The ppo plan should have been canceled as of 12/31/10 — in fact, I never chose it; should have been on the hmo all along.
Thank you
Rita kelley

The information transmitted is intended only for the person or entity to which it is addressed and may contain confidential material. If you receive this material/information in error, please contact the sender and delete or destroy the material/information.

The information transmitted is intended only for the person or entity to which it is addressed and may contain confidential material. If you receive this material/information in error, please contact the sender and delete or destroy the material/information.

The information transmitted is intended only for the person or entity to which it is addressed and may contain confidential material. If you receive this material/information in error, please contact the sender and delete or destroy the material/information.

  • De
    Debra Macdonald Sep 02, 2015
    This comment was posted by
    a verified customer
    Verified customer

    I have just found out the same as above. What a scam. They told me on the website when I went to pay I was not a client after I had been paying for 6 mos. My Debit card was stolen and I had to change it. They could not take the $22.00 out of my bank so they contacted me in a letter. I tried to pay online then by phone.the same thing. .When I got a hold of a person they said the digit was wrong not a 9 at the end but a 3.. Wow, They are trying to call me back now, three times. This just happened. I could hear that it was so weird in th woman's voice. You would think I would learn and check the internet scams before I send money. I feel so foolish.

    0 Votes

bad medix d

Humana walmart medix x plan is awful they dont send drugs on time they overcharge and you have to wait a month to get credit 180.00 dr wrote prescription for drug they wouldnt fill it said needed preorthorization my dr did this they still wouldnt they denied the claim. I spoke with nurse at my drs. Office told her tell your friends to stay away from humana. Oh thats old news they over charge the always deny preorthorization. We have
Known how bad they are for a long time